Manuals and Forms
- 2019 Medicare Provider Manual (PDF) - Reference for Trillium Advantage product
- 2019 Trillium OHP Provider Manual (PDF)
- 2019 OHP Billing Manual (PDF) - Reference for Trillium Medicaid (OHP) product
- Provider Redetermination Request Form (PDF) updated 7/19/2019
- Outpatient PA Form (PDF)
- Inpatient PA Form (PDF)
- OHP Pharmacy PA form (PDF)
- OHP Non-Formulary Review Request Form (PDF)
- Pharmacy Lock-In Referral Form (PDF)
- Prior Authorizations and Appeals Guide (PDF) - effective January 1, 2019
- ARQ Changes Frequently Asked Questions (PDF) - effective April 1, 2017
- Secure Provider Portal - Check eligibility, PA's, claims for dates of service after 2016
- LineFinder - Search for a diagnosis, procedure, or service
- National Imaging Associates (NIA) - Submit prior authorizations for non-emergent outpatient advanced imaging.
- ERA Form (PDF) - EDI-Sign up for Electronic Data Interface (electronic claims submission)
- PaySpan - Signup for Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT).
- Find a Provider: Medicare | Medicaid - Search for a participating provider in our online Provider Directory
- Trillium Preferred Drug List (PDL) List of Covered Drugs for 2019 - Oregon Health Plan (PDF)
- Trillium Preferred Drug List (PDL) List of Covered Drugs for 2019 - Oregon Health Plan (JSON)
- NUCC Guidelines (PDF) - Instructions on how to complete the 1500 Claim form
- OHP Contraceptives Chart (PDF)
- Trillium Preferred Drug List Alternatives (PDF) revised 8/1/2019
- Trillium Qualified Medicare Beneficiaries Billing (PDF)
- Provider Newsletters
- Living Well Self-Management Programs Living Well is a series of Self-Management Programs developed by Stanford University to help you live and cope with a range of chronic conditions. Workshops include Living Well with Chronic Conditions, Living Well with Diabetes, and Living Well with Chronic Pain.
- Trillium Community Health Plan promotes adherence to the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) periodicity schedule. View the Recommendations for Preventive Pediatric Health Care schedule of screenings (PDF) from the American Academy of Pediatrics.
- Trillium is pleased to introduce the Choosing Wisely initiative. The American Board of Internal Medicine (ABIM) Foundation encourages practitioners and patients to "Choose Wisely." This initiative seeks to advance a national dialogue on avoiding unnecessary medical tests, treatments and procedures. Please visit choosingwisely.org to download informational resources for your patients and clinicians to promote shared-decision making.
Network Participation Requests
- Physician Network Participation Request Form (PDF)
- Ancillary Network Participation Request Form (PDF)
Member ID Card Samples
- Trillium Medicare Advantage Member Card - Front (PNG)
- Trillium Medicare Advantage Member Card - Back (PNG)